In this episode, “Mythbusting Reel from Real Diagnosis” we explore the complex and often problematic relationship between social media and self-diagnosis. As platforms like TikTok, Instagram, and Twitter give us access to endless information on mental health, they can also be a double-edged sword. While some of this content can be empowering and educational, much of it falls into the realm of misinformation. We discuss how popular online content about mental health diagnoses can mislead, oversimplify, or even completely misrepresent the conditions it seeks to explain. In this episode, we dive into some of the most talked-about mental health conditions on social media. We break down the actual diagnostic criteria, prevalence rates, and symptoms to provide clear, accurate insights. And we look at how the trend of self-diagnosing through social media impacts the work clinicians do, making it harder to provide precise diagnoses and care. Stay tuned for a nuanced look at what social media may be getting wrong about mental health—and how to be a more informed consumer of online content around self-diagnosis.
Creators & Guests
Host
What is The Shrink Down?
Four lifelong friends, all clinical psychologists, unpack the latest in current events, pop culture and celebrity news through the lens of psychology.
Vanessa (00:01.179)
Welcome to The Shrinkdown. In today's episode, we will be exploring the complex and often problematic relationship between social media and self-diagnoses. So platforms like TikTok, Instagram, and Twitter give us lots of information on mental health, which can be helpful, but it can also be really misleading and give us misinformation. So today we'll be discussing how popular online content about mental health diagnoses can mislead, oversimplify, or even completely misrepresent the conditions it seeks to explain.
We'll also be diving into some of the most talked about mental health conditions on social media. We'll give you like key aspects of diagnostic criteria. We might even give you some rates, prevalence rates and symptoms for each of these to give you a better understanding of what each of these truly is. And we'll talk about how this trend of self diagnosing through social media really impacts the work that we do as clinicians and how that can make things trickier for us. But before we jump in today's important discussion, we're gonna kick things off with our favorite, our four minute faves.
This is something that we've kind of gotten a lot of feedback about that this is also a lot of people's favorite part of our podcast. So this is where we share something we've loved for a long time or something new we've come across. All right, so let's get into it. Lauren, do you want to start us off today?
Lauren (01:08.441)
Thank
Lauren (01:12.159)
Sure. So I actually watched something new this week, you guys. I was so proud of myself. That's not to say that Tim and I are not still trucking through the same series that we've been trucking through, but I actually found some time to watch something separately that I had been hearing a lot about kind of in the zeitgeist, while it's actually English teacher on Hulu.
It's a comedy and it's like 22 minutes. So this is why this works for me. I know. And there's only one season. It came out in September. Eight episodes, I think. pretty bite-sized. But it stars, okay. And Wilhelmina, you might know this person, Brian Jordan Alvarez. He's the starring creator of it. He was in Jane the Virgin.
Wilhelmina (01:37.757)
perfect time. Yes.
Wilhelmina (01:53.378)
His... Okay. His picture looked familiar, because you had sent it to me and I was like, he does look familiar.
Lauren (01:59.709)
Okay, I said, yeah, yeah. Yeah, so he's the the star and the creator. So he's the English teacher at a high school. And the premise is super simple. It's really just about like him navigating his personal, professional and then the political climate of adolescence. And they do it in such a humorous but respectful way. It really will actually it touches on some of the themes of what we're touching on today, sort of
Teri (02:24.714)
you
Lauren (02:28.251)
social media impact and influence on adolescent behavior and presentations at the high school level and things like that. But they do it in a really, really funny way, really intelligent way and respectful, of course. And so I've only watched a few episodes, but it's really, really, really well done. And you don't really need to know anything beyond that. It's like a perfect little bite-sized comedy. So that's what I'm loving. Yes, I highly recommend. Yes. Exactly.
Wilhelmina (02:51.992)
I love a good small comedy that you can just fit in here and there.
Lauren (02:58.134)
What about you, Wilhelmina?
Wilhelmina (02:59.886)
So I am talking about something I've actually loved for a long time, and that is Orange Theory Fitness. So I started going there. I was actually trying to think about it. I think I started going there when both Maddie and Griffin were in school full time. And I was looking, I was just sort of bored of my workout routine. I was sort of like, I go for runs, I go on my elliptical, I do some yoga. I was like, I need to do something different. So I'd been hearing a lot about Orange Theory at the time, and I went and I just,
Lauren (03:07.379)
Yeah.
Wilhelmina (03:30.15)
I had so much fun and instantly went home and told my husband, I was like, you need to go to this. You are going to love it. And he hates spending any amount of money. So he was like, we already have a gym membership. We have a gym membership. I can just go outside and run. I don't need that. And I was like, you're going to love it. He went and like, he's like, okay, you're right. It's, it's amazing. so the way it's set up is it's like an hour long class and 30 minutes is usually like kind of some sort of
Vanessa (03:41.085)
Thank
Wilhelmina (03:58.03)
cardio, whether it's treadmill, rowing, combination of both, and then you do about 30 minutes and they're kind of weights. Like the workouts are always different. So you go in, you never will have the same workout. And then you have a coach that's sort of like a personal trainer sort of thing. So like she's there for the class, but if you're lifting weights, she'll be like, move your backpack, arch, yeah, correcting. So I like that.
Vanessa (04:20.494)
Correcting, yeah.
Wilhelmina (04:24.918)
And it's just fun, good music. I've done it with some friends. pulled them in. It's just great. And this week they're doing Hell Week, which is so fun. So you do like it's for eight days. And if you do four workouts, you get a t-shirt, which you of course pay for, but you only get the t-shirt. It feels great. But I've never been so proud of like a black orange theory tank top in my life as these Hell Week.
Lauren (04:33.747)
Yeah.
Lauren (04:41.151)
It feels really good!
Lauren (04:48.813)
There.
Vanessa (04:53.885)
That's so funny.
Wilhelmina (04:54.158)
Now I will add that just recently I was listening to a woman talk about like women and perimenopause and workouts and how they should change their workouts. And she actually put down specifically orange theory, but she did lump it in with like spin classes and all that. I'm like, but it's not that. So I think I, I think I got what she was saying, which is that for women, we really need to kind of do more strength focused and not just.
Lauren (05:03.753)
Yeah.
Wilhelmina (05:21.218)
get into the red zone and orange zone. So I've actually just been changing it a little bit and paying a little bit more attention to my heart rate and keeping it just a little bit lower and trying not to push myself, but not go to that max. And then weights get heavier weights. I've actually, I just do it once. Yes, yes.
Vanessa (05:21.373)
straight cardio. Yeah.
Lauren (05:23.081)
Right.
Lauren (05:29.577)
Yeah. Yeah.
Yeah.
Lauren (05:38.185)
You can kind of modify on your own. That's perfect.
Vanessa (05:39.557)
Yeah, yeah. My sister's a big Orange Theory person and she took me when I came to Chicago. And like, it's so funny because I work out but I don't do those workouts. And Wilhelmina, you're right. Like they are like really like, they're fun, they're quick, you know, they're fast. And I was like, yeah, I got this. And so it got to the treadmill part and I'm not a treadmill person. And my sister is and you can like it keeps track of your workouts on the boards, you can see what other people are doing. So like I look over my sister and she's like rolling ass on the treadmill. was like,
I can't let you beat me. I'm like killing myself to keep up with my sister. But it is a really fun workout. Definitely.
Lauren (06:07.903)
You
Teri (06:08.017)
Thank
Lauren (06:12.767)
How many people are in the class at any given time?
Wilhelmina (06:12.824)
it is.
Wilhelmina (06:16.098)
You know, it ranges. you could have, there is a max, but very rarely it hits it. And if they get too close to a max, they'll actually divide it into three. So they'll have like a tread, rower and floor and you'll go between. So I've never not been able to get into a class now. Sometimes they do fill up. Like, I know if you go to like the 5.30 AM workouts, which Lauren, I think you would probably do. I don't, I don't do those. So my friends who do the, those are, she's like, she's on there like,
Vanessa (06:18.845)
But there's a math.
Lauren (06:38.889)
That sounds perfect. But those are probably popular. Yeah.
Wilhelmina (06:45.932)
the month before it opens and she's booking those. So I don't have to worry about it. So I, yeah, I love it. I just do it once a week. Like I know people who do it, like that's all the time. And I'm like, that feels like that. Yeah. So just once a week, it's delightful. I love it. Terry, what are you loving?
Lauren (06:47.816)
wow. Yeah. Yeah.
Lauren (06:54.855)
Nice.
Vanessa (06:56.529)
all the time.
Teri (06:58.698)
That'd be a lot.
Lauren (07:03.508)
Nice.
Teri (07:05.416)
Okay, I am loving and it's probably called something different depending on where you go, but a hair and scalp treatment. So almost like a facial for your hair and scalp. My friend and I this past Friday went to a place in Chicago called O Spa, the letter O. It's in River North. I'm sure other spas wherever do this, but you lay flat on your back, like on a massage table and your head hangs over the sink.
Lauren (07:28.456)
Yeah.
Teri (07:35.112)
or whatever the basin like you would when you go to a salon, but you're laying flat and it's an hour long and there's water streaming that goes over and they scrub the heck out of your head. And they do it a couple different times. It includes a massage, but the beginning of it, they actually give you this little pen camera that you put in different parts of your scalp. And then they look at it on a camera to see what your skin looks like. Like if there's
Vanessa (07:38.034)
Mm-hmm.
Lauren (07:38.143)
Yeah.
Teri (08:03.294)
dead skin or dry skin, if the certain areas need more exfoliation, behind your ears or in the back. So I just, was, and then at the end, they sit you up and they blow dry your hair. And it's, that part was kind of weird, but, and because it wasn't, it wasn't like a salon blow dry. It had a different, it had a different vibe. But however, I would highly recommend.
Vanessa (08:05.869)
Hahaha!
Lauren (08:07.155)
Hmm.
Lauren (08:17.375)
Hmm.
Ha!
Wilhelmina (08:20.12)
Hahaha!
Vanessa (08:20.47)
Hahaha!
Lauren (08:23.754)
Yeah, nah.
Teri (08:29.33)
I will definitely be getting it done. My friend who I was with, we were talking about how maybe at the end of the winter or even before with different seasons or after the summer when you're putting sunscreen and just all sorts of junk and product builds up like in your hair and at the follicles, it was very good. There at O Spa, was called scalp and spa or scalp and hair treatment, something, but.
Lauren (08:37.119)
That's a good idea. Yeah. Yeah.
Lauren (08:43.091)
Yeah.
Lauren (08:46.785)
nice.
Vanessa (08:52.189)
probably do that. I'm like a big like you guys know that I dry shampoo like a crazy person like I wash my hair like once a week like I probably need that.
Lauren (08:54.015)
That sounds nice.
Teri (08:56.074)
Ohhhh
Wilhelmina (08:56.289)
yeah. huh.
Lauren (08:56.798)
Yeah.
Teri (08:59.067)
You should do this.
Lauren (08:59.123)
Nope. Yeah.
Wilhelmina (08:59.95)
I was gonna say when Terry said they took a camera and they're like, you have a full inch of dry shampoo.
Vanessa (09:05.469)
That's me. there a scalp here, ma'am?
Teri (09:09.426)
It was, yes, it was, it was great. Highly recommend.
Wilhelmina (09:09.55)
You
Lauren (09:14.394)
That's a good idea. That would be a good, like a good gift, I would bet. Yeah.
Teri (09:18.366)
Yes, yes. How about you, Vanessa?
Vanessa (09:20.861)
All right, facial first out. So I actually watched a documentary. I was in Nashville over the weekend with some of my girlfriends celebrating a 40th. And this was the day after we had gone out. We needed a day to recuperate. And so we watched the, it's a Netflix three-part documentary on the Zodiac Killer. Do you guys remember that? Like, yeah, okay. So this just came out. And so it's called, Is the Zodiac Killer.
Teri (09:44.488)
I do, I do.
Lauren (09:44.811)
yeah.
Wilhelmina (09:44.848)
yes, uh-huh.
Vanessa (09:50.201)
And so the documentary really focuses on this set of siblings who knew the person who was basically the primary suspect was never charged and has now passed away. But his name was Arthur Allen Lee. So this documentary focuses on these siblings who are now in their 60s, 70s.
It also they interview them. They also interview some of the key players. So there was a a journalist who's actually a cartoonist for one of the newspapers who received a letter from the Zodiac Killer. So this was somebody, a serial killer in the late 60s and 70s who started sending letters to different news media and then also these basically coded letters. So he would send letters saying that he had murdered people.
or that he was going to, telling him kind of what he did or what he was going to do. And then these coded kind of messages too that he was sending. And so this guy was one of the, worked for this newspaper and got really into this, you know, this series of killings. And so he wrote a book and the book was then turned into a movie in 2007 called The Zodiac. Yes. Yes. So that's with Jake Gyllenhaal, Mark Ruffalo, Robert Downey Jr., right? It's got like a 90 % rating on Rotten Tomatoes. So it did really well.
Wilhelmina (11:02.894)
I've seen it.
Teri (11:03.55)
Same. Yeah.
Lauren (11:04.025)
That's I think I've seen it. Yeah. yes.
Vanessa (11:12.793)
And so in this film, they, sorry, this documentary, they talk to this guy who wrote the book, who then turned into a movie. And so, but it really focuses on these siblings whose mother befriended this primary suspect, Arthur Allen Lee. And so they went and watched this movie that came out in 07. And as they're watching it, they realize all of these things about the time that they spent with him and how they align to a lot of these murders.
Wilhelmina (11:28.206)
Hmm.
Vanessa (11:42.481)
fascinating. So it's basically like stuff that's probably not in the movies because they didn't share this information with anyone because they were children at the time when these things were happening. But it's very interesting. Really loved it. So if you liked that movie or you read the book or you've just come across something about the Zodiac Killer, I would highly recommend the documentary. It was really good. I will say that it left me wanting to know more about this suspect, this guy, like
Lauren (11:46.439)
Right?
Lauren (11:54.441)
Right.
Lauren (11:58.867)
and
Vanessa (12:11.077)
And I tried to Google to find out more information about him. And there really isn't a lot. I'm fascinated about what his background story is, because there's all these things. he was, this isn't a secret, but he was incarcerated at some point for child molestation. He was a teacher. He's got a lot of things. And so you just wonder where he came from psychologically, what kind of triggered a lot of these things. But it's really good. And like I said, this is all kind new information.
Lauren (12:33.203)
Right.
Vanessa (12:39.623)
that's kind of come out since this book, since the original movie in 2007, that's really focusing on these different adults now. No. He was the primary suspect. A lot of people pointed the finger at him. There's a lot of things that even, so then after that movie, the oldest brother from this sibling group reached out to police and was like, I just want you to know these things.
Wilhelmina (12:47.436)
And remind me, he was never caught or found. Like he was just a suspect and then that was.
Vanessa (13:06.087)
So even with all of these different people and they kind of go through all of this in the documentary, they still never found enough kind of clues. I think it would be totally different if it was today in age with the technology we have. I just don't think we had the technology back then to be able to. And there's still actually two letters that were sent in that have never been decoded. So there's still, like this is still an active investigation because it was never kind of, and they've interviewed a bunch of the different police who were involved.
Teri (13:12.807)
evidence.
Lauren (13:13.503)
Crazy.
Teri (13:17.585)
Absolutely.
Lauren (13:17.673)
Sure. Yeah.
Wilhelmina (13:26.399)
wow.
Vanessa (13:34.277)
in this, like there's like the new cold case crime guy who's kind of working this. But it's really fascinating just how this kind of progressed and all this new information and how we never actually figured out who did this. Although I strongly believe that they had the right guy. They just did not have enough evidence. Yeah. Yeah. So it's three part series. So it's not super, super long. It's really good. Yeah.
Lauren (13:34.558)
Mm.
Teri (13:50.985)
enough evidence.
Lauren (13:51.273)
There was just not a formal charge. Hmm. Interesting.
Wilhelmina (13:51.276)
Enough.
Wilhelmina (13:57.931)
Sounds right up my alley and yours Mary.
Lauren (13:59.867)
It does. Yeah. Yeah.
Teri (14:00.232)
Yeah, I want I'll watch that. Yeah.
Vanessa (14:00.765)
Yeah, it's like murder and mystery. I'm telling you, it's really good. Now I want to go watch the movie because I don't know. I don't know that I watched it. I was trying to think of like, what was I doing in 07? I was on internship year. was like, maybe I was just so overwhelmed that year that I missed it because I was like, what was I doing in 07 that I don't recall watching this movie?
Lauren (14:07.059)
Yeah, I remember it.
Wilhelmina (14:07.564)
I watched it for sure.
Lauren (14:14.077)
Hahaha
Wilhelmina (14:20.728)
I remember liking it, it was definitely, you know, there's a lot of like serial killer movies and it was definitely a more kind of, because there was so little evidence that it was a lot of the newsroom. was a lot of that sort of stuff. wasn't as like, I don't know. Yes, yes, as some of them. Yeah. So I think if I watched it again, I'd probably even like it more, but I think I went into it being like, ooh, this is going to be like copycat or something. And it was not.
Vanessa (14:34.994)
Yes.
Teri (14:37.983)
Sexy.
Lauren (14:39.599)
And gripping, yeah, yeah.
Teri (14:40.851)
Yeah.
Wilhelmina (14:50.222)
Copycat being a fictional movie with Sigourney Weaver that's way back in the day.
Teri (14:55.028)
Thank you. I have no idea what that was.
Lauren (14:56.633)
Okay.
Wilhelmina (14:56.768)
I was like, I said it. I know I said it like everyone knew it was. Yeah.
Vanessa (15:03.985)
All right, so as I mentioned earlier in today's episode, we're gonna be exploring different popular mental health conditions that we see all the time on social media. So we've each picked one that we feel like we've either heard clients coming in talking to us about a lot, or even just in our social circles, people will say, you know, be talking about these particular diagnoses. So we've each picked one that we're gonna talk about today, give you some information about it, kind of hear, what do we hear from clients and people that we know, what's accurate, what's not accurate.
and kind of how this makes things complicated for us as psychologists and then moving forward with an actual diagnosis when it's warranted. Wilhelmina, do you want to start us off today?
Wilhelmina (15:43.148)
Yeah, so I actually am not going to be talking about a specific diagnosis per se, but more a term that I work with a lot in my practice and it comes up pretty much with almost every patient it seems at some point. And it's the word trauma. So trauma is used all of the time these days. And I was actually talking to my husband about this and he said,
You guys could do like a whole episode on that. like, I know and we might and we might, but I'm right, right. So I was writing some things out and I said, the funny thing is I actually think that among 20 year olds, like 20 year olds and adolescents, the word trauma is overused and used incorrectly. And then I would actually say from like forties onward, it's like,
Lauren (16:14.975)
Yeah. Yeah. Yeah. Yeah.
Teri (16:16.564)
We could do 10. I like to say trauma is hot. Trauma is very hot.
Vanessa (16:18.725)
Yeah.
Wilhelmina (16:42.964)
underused. Yes. Like, I will have people tell me these like events from their childhood and like parenting, like stuff with their parents. And then I'll be like, wow, that's a lot of that's a lot of intense like trauma. And they're like, no, I had a great childhood. I don't have any childhood trauma. And I'm like, you literally just defo. Okay. Okay. So you don't know what trauma. And so that's, guess why I picked this one.
Lauren (16:43.227)
Under you. Yep.
Vanessa (16:43.355)
underused.
Teri (16:44.382)
Hmm
Lauren (17:02.643)
You
Wilhelmina (17:08.946)
so I will try to keep this as concise because again, this is literally something I could spend hours talking about. so I'd, I'd break it down between what is called like big T trauma and little T trauma. So big T trauma is I guess what most people think about when they think about trauma. So PTSD, an event where your life was threatened in some way or
Lauren (17:22.463)
Yeah.
Wilhelmina (17:36.206)
Threatened harm, threatened death. So think of like child abuse, obviously rape, even things like car accidents that were very traumatic. So that's where you get these big T traumas. Tornado, yeah, yes, yes, absolutely. And I would say there's probably some collective trauma from like COVID, things like that. So that's like big T trauma. But then you have what I call little T trauma.
Teri (17:47.786)
tornadoes, especially lately.
Lauren (17:49.363)
I was going to say a natural disaster. Yep.
Vanessa (17:50.014)
yeah, weather, significant weather events, yes.
Wilhelmina (18:05.966)
And little t-trauma is actually kind of part of the human experience. So we all have these moments and they aren't necessarily about what the moment is. So if someone were to tell you about it, someone might be like, well, that's not a big deal, but it's how we internalize it emotionally within us. And so many of the events that become part of like who we are happen when we are really, really young.
And we sometimes don't even have physical memories to go with them. And so they become these parts within us, which actually Richard Schwartz, who is the creator of Internal Family Systems, IFS, he talks about how we have these like parts that come up and these exiles. I won't even go all into that, but they come from these like trauma points. And these can come from
They're non life-threatening events that cause some sort of internal distress or disruption So and then it's often the accumulation of these events that can cause significant distress so think about a mismatch if you will between a parent's personality and a like a child's personality No one's at fault. No one's to blame, but if you have a big feeling kid
He just can feel, he or she can feel all of the emotions. They feel it all intensely. They know the tenor of the room. And then they have a parent, maybe a parent who's on the spectrum, but you have a parent who is like very reserved with their emotions, don't understand the emotions. They're gonna respond to that kid in a way that is confusing to the kid. And the kid is gonna grow up thinking, there must be something wrong with me. I'm too much. I'm too like,
Lauren (19:47.155)
Mm-hmm.
Vanessa (19:56.125)
Okay.
Lauren (19:56.819)
Right.
Wilhelmina (19:59.694)
I'm broken in some way, something's wrong with me, I'm not lovable, like I'm making, it's personalized for each person. And so that would be little t trauma. And again, this isn't a blaming. So a lot of people are like, it's always the parents. This is not a blame. This is literally, it's an explanation. And again, as I said before, it's part of the human experience. We all have these, are part of us. And if you actually think about it,
Vanessa (20:14.769)
Yeah
Lauren (20:15.965)
No, it's just like a fit. Yeah.
Teri (20:16.38)
It's an explanation.
Lauren (20:22.237)
Yeah. Yeah.
Wilhelmina (20:27.982)
For anyone who saw Inside Out, the newest one, a lot of these events are kind of these core, they become these core memories that sometimes aren't even, again, memories, we actually have like physical memories, and then they become part of how we define ourselves. And so, yes, so if we're defining ourselves based on these trauma points, it can kind of start to wreak havoc as we get older, especially I've seen as we become parents ourselves.
Lauren (20:30.899)
Yeah.
Lauren (20:44.575)
we identify.
Teri (20:57.056)
huh.
Wilhelmina (20:57.228)
And we start to respond in ways to our kids and have feelings that come up around our kids. We're like, whoa, what is this? Why am I having this response? And that's when I've seen in my practice, we start doing a lot of parts work. We start looking at a lot of things and a lot of those internal messages. So that's, but I think we all can relate to the fact that we have so many, hear especially teenagers like, my gosh, some, I.
Lauren (21:21.151)
Yeah.
Vanessa (21:22.128)
yes.
Wilhelmina (21:23.852)
My dad did this and it was so traumatic. I have trauma from it. I have PTSD from it. They'll say these things. You're like, no?
Lauren (21:26.323)
Right?
Lauren (21:31.135)
Can I ask you a question? What's a better word to define what you're talking about as those trauma points or the little T trauma? Because I think if we can encourage and spread better language surrounding what you're talking about, which I think makes a whole lot of sense, I mean, it makes a lot of sense to us as clinicians, but just as human beings, we all have those moments, right? But yeah, to use that and to term those moments as trauma or PTSD and just
throw that term around really miscategorizes what actual trauma is. What language would be helpful?
Wilhelmina (22:03.522)
Yes.
Teri (22:04.234)
Mm-hmm.
Wilhelmina (22:09.1)
That is a great question, Lauren. I think, and I have thought about that and we absolutely need a different word, whether it's a different word to define this or it's a different word for other people to use in those instances. And I don't know really what it would be, but I think. Yes, yes. Like a.
Lauren (22:11.25)
I'm just throwing it out there.
Lauren (22:19.602)
Yeah.
Lauren (22:27.229)
Almost like defining moments, like good and bad, right?
Vanessa (22:29.883)
Yeah. Well, I think that I was just gonna say, I think that one of the other hard parts about the like little T-trauma is that it's so, like you said, personalized. Like I may experience the same exact situation, but I don't, it doesn't become like, I don't interpret it because maybe my personality is different or whatever, something going on with me in my life is different. And so I think that is really tricky about how then people then interpret those.
Lauren (22:40.957)
Yeah. Yeah. You don't interpret it as a point, right?
Wilhelmina (22:41.112)
Yep. Yep.
Lauren (22:57.044)
Right?
Vanessa (22:57.177)
even from the outside, like, how could that be traumatizing to you? Because I've experienced similar or even the same and I don't feel that way. So I think that adds to the difficulty in those little t traumas. And yeah, uh-huh. Yeah.
Wilhelmina (23:05.56)
Yes.
Lauren (23:07.667)
Yeah, in the language or surrounding it.
Wilhelmina (23:10.854)
Well, siblings, I mean, to your point, Vanessa, siblings in the same household, they all have different relationships with their parents because they are different. Their own personality type and the way they experience emotions and receive information is different than their other siblings and it's different than their parents. So each person has a unique relationship with their parent or parents. So therefore, they each can have their own
Lauren (23:12.948)
Yeah.
Vanessa (23:14.493)
Mm-hmm.
Wilhelmina (23:38.55)
like experiences, these little T traumas that are going to be different and they might've all been together for it. Yeah, yeah. So yeah, I think it does need something different because it's too many traumas. it's used too often and most
Lauren (23:40.349)
Yeah.
Teri (23:43.828)
Right? Right? Right.
Vanessa (23:43.896)
Same environment, just different experience.
Lauren (23:52.639)
Right.
Lauren (23:56.979)
Yeah. Yeah.
Vanessa (24:00.551)
And then it takes away from the really seriousness of trauma.
Wilhelmina (24:03.17)
Yes! Yes.
Lauren (24:03.205)
Absolutely. Right.
Teri (24:04.334)
With teenagers, I often differentiate between anxiety and stress because anxiety is another term that gets grossly overused. And so is it stressful versus anxiety? And stress and anxiety is a part of the human condition and stress is a part of life. But throwing around terms that I hear a lot from teenagers especially is, so much anxiety. have an anxiety disorder. It's my anxiety, it's my anxiety.
Lauren (24:10.387)
Right. I it's thrown around. Yep.
Wilhelmina (24:12.62)
Yes.
Wilhelmina (24:22.466)
Yes.
Teri (24:33.276)
when at the current time we live in, we use that term in a very specific way. And so for the time being, while we still use anxiety, the way it was intended to be as an operational definition, we're going to differentiate, is this anxiety or is this stress?
Lauren (24:49.673)
Mm-hmm. Yeah. Yeah.
Wilhelmina (24:50.136)
That's a great, yes, absolutely. And I think that because these little T traumas are part of the human experience, just like stress is part of everyone experiences, it probably does need a different name, because it's not something that we all have it. just depends what it is.
Lauren (24:57.523)
Yeah.
Lauren (25:01.225)
Right. Yeah. Yeah. Interesting.
Teri (25:03.412)
Right. Exactly.
Vanessa (25:09.293)
Lauren, what are you sharing with us today?
Lauren (25:11.583)
Okay, so I guess I was going to say lightening the load a little bit from trauma, but really it's not because in the same vein when we think about the sort of miscategorization of some of these terms, I'm going to talk about OCD and OCD really does get thrown around in the social media world as a representation of sort of a personality type, right?
Wilhelmina (25:16.686)
you
Vanessa (25:17.423)
You
Wilhelmina (25:26.304)
Mmm.
Vanessa (25:29.277)
Mm-hmm.
Wilhelmina (25:29.901)
Yes.
Lauren (25:36.983)
And there is an obsessive compulsive personality disorder. That is not what we are talking about, but rather this idea of I'm so OCD, I've got to organize the dishwasher after my husband does it, right? Reorganize the dishwasher, right? Like that kind of term, there is a whole population of social media users that are misrepresenting the term to really characterize what means tidy and organized.
Wilhelmina (26:05.27)
Mm-hmm. Mm-hmm.
Lauren (26:06.191)
And what OCD is, as we all know, is a psychological disorder characterized by obsessions and compulsions. And those aren't things that we are throwing around that include neat and tidy, but rather obsessions are really unwanted, distressing thought patterns that somebody experiences, okay? And they do not want to have those types of thought patterns. They can...
there are different sort of categories that we will see clinically from an obsession standpoint. They can be themes like doubt, contamination, harm, religious or unwanted sexual thoughts, perfectionism, fear of losing control. And what happens as a way of sort of ameliorating those obsessions or reducing the stress and anxiety those cause, which they do,
Teri (26:41.236)
Mm-hmm.
Wilhelmina (26:45.25)
Mm-hmm.
Lauren (26:58.255)
people will develop compulsions or repetitive behaviors as a way to sort of control their obsessive thinking patterns. Now, they can just have compulsions as well. But these compulsions or these repetitive behaviors that aren't aren't realistically going to do anything to the obsessive thought patterns, right? But it feels that way for the individual for a period of time. And it's really aimed at kind of reducing or they believe to prevent the thing that they're obsessively
Vanessa (27:01.831)
Mm-hmm.
Lauren (27:27.979)
thinking about. So compulsions can include things like cleaning, checking, ordering, repeating asserting behavior, counting behaviors. Yeah, so that would be under the cleaning, right? So behaviors that become in the same way that obsessive thoughts are distressing and unwanted, these compulsions become time consuming and distressing in and of themselves. It's debilitating.
Teri (27:33.226)
Thank
Vanessa (27:34.589)
counting.
Teri (27:36.972)
Hand washing.
Vanessa (27:39.224)
undoing things.
Teri (27:41.076)
Yeah.
Wilhelmina (27:52.674)
Yeah.
Vanessa (27:53.009)
Yes, so debilitating.
Lauren (27:56.955)
And so the problem that we, I believe we all see, and I know we do because we talk about this on a regular basis, is people coming into the office. And these can be adolescents, young adults, but we also see this out of parents as well, where they'll say, think, did you see OCD? I think there's some OCD there. And in reality, that's not.
Teri (28:16.22)
Mm-hmm.
Wilhelmina (28:16.788)
You
Lauren (28:19.401)
what actually is occurring. And so it's that mis-categorization. This might be somebody experiencing anxiety related to performance. And so there's a little perfectionism and they're slow in their approach to completing a task for academics, for example. Okay. And that is a real thing and something that we absolutely would clinically diagnose as well as treat, but it's very different from the treatment and the diagnosis that would be involved in a true obsessive compulsive disorder.
Vanessa (28:34.429)
Mm-hmm.
Vanessa (28:47.997)
capacity.
Lauren (28:49.501)
Now, what's interesting is in doing some of the research, just kind of, we had all talked about this and we knew this was a term that we were hearing quite a bit. But in doing a little bit of research, because I am not somebody that is on TikTok, so I did a little research in that regard, there is a smaller population and mostly women of individuals that have been diagnosed with obsessive compulsive disorder that are describing actually what it is. Okay, so they've gotten real diagnoses from clinicians.
Vanessa (29:01.853)
You
Lauren (29:18.705)
of this disorder. And I wanted to just read one of the things one of the users said, and I just I thought it was such a nice way of describing what it actually is versus what it is not. And this person said, OCD is not cute. She doesn't wear big glasses and chunky sweaters while she neatly lines up her stationary and color order. She's probably the most misunderstood disorder to the point where people nonchalantly use her name to describe a neat person. And then she goes on to say,
Wilhelmina (29:46.392)
Mm-hmm.
Lauren (29:48.583)
This is what people don't usually see. And she tells kind of an overview of her thought patterns. Did I tell my mom I love her before she went to bed? What if she dies on the way to work tomorrow? Should I wake her up and tell her just in case? No, that'll make her mad. Wait, did I lock the doors? Did my sister make it home safe? She didn't text me. Her location is off. she's fine. She just responded. Wait, should I check the locks again? So just a really nice, I think, example of this is not neat and tidy. And so to throw that term around makes it tricky for us.
Wilhelmina (30:13.645)
Mm-hmm.
Vanessa (30:13.681)
Mm-hmm.
Lauren (30:17.541)
as clinicians when they're coming in looking to see if they have this diagnostic pattern when they don't really truly understand what it is. And so that misinformation that's out there is really important to correct.
Vanessa (30:29.499)
Absolutely.
Wilhelmina (30:30.444)
Lauren, really liked your example of the, you this isn't someone who is stacking their papers neatly. Like, because I know so many people that are like, my gosh, my kitchen, I have to have it. I'm just, I'm pretty OCD around my kitchen. I just, you know, I gotta clean the counters and all that. I'm like, no, you're just clean. You just like, you're tidy. Yeah. Or like, when I'm changing the volume on my TV, I need it to be an even number. I'm totally OCD like that. I'm like, that's not.
Teri (30:30.773)
Well put.
Lauren (30:36.115)
Right.
Lauren (30:41.224)
I'm
Lauren (30:48.595)
Right. You're tidy.
Vanessa (30:51.879)
your needs.
Teri (30:52.23)
Okay.
Lauren (30:59.411)
Also, and do know how many people say that? That alone, right? The prevalence rates of OCD between 1 and 3%. I mean, so the amount of people that say exactly what Wilhelmina just said should tell us right away. Like that is not exactly what you're talking about because it is the true diagnosis is so it is pretty rare in the population. So it makes it harder. Terry, God.
Wilhelmina (30:59.562)
that's just a quirk.
Wilhelmina (31:07.502)
Yes.
Wilhelmina (31:21.804)
Yeah, it is.
Vanessa (31:25.873)
And I think people have like the most popular, I think, version of OCD is like that germs cleaning thing. So I think people get hooked on that and they don't realize how elaborate OCD can be. I can remember when I was an intern, the first, one of my first therapy cases was a teen whose parent didn't even realize that the child had OCD. They were just like, I think there's some anxiety there. I'm not really sure. And when I got really into it with this teen, I was like, my gosh.
Teri (31:31.85)
Mm-hmm.
Wilhelmina (31:31.95)
Mm-hmm.
Lauren (31:38.919)
Yeah.
Lauren (31:48.168)
Right. Right.
Vanessa (31:54.725)
it was consuming his life, like checking and rechecking and doing and undoing. And I mean, over and over and over before he even walk out the door, like, right? And so it is very debilitating. And even just the things that go on sometimes in their mind, they're not even doing anything. It's just in their head, they are having to do certain things or avoid certain things, you know. But I think people have gotten pretty savvy about, know, sometimes I've had teens who've come in and they've said, well, I can't step on like they're rattling off.
Lauren (31:56.957)
Yeah. Yeah. Yeah.
Yep. Yep.
Lauren (32:09.535)
Yeah.
Vanessa (32:24.145)
things that are definitely more in the OCD realm, but you're like, okay, and if you didn't do that, what would happen? Well, I'd be okay. And then I'm like, well, there you go.
Lauren (32:24.765)
Right. Right.
Lauren (32:30.879)
Right. The other thing that I love to ask is if anybody else observes it. Because people don't actually, when a parent is like, I have never seen that, it's very unlikely that this is actually occurring because it is such a significant impact in these individuals' lives that people around them know exactly what is happening when they have to wait at the door while that person checks the lock eight times before they leave the house. Or something to that effect.
Teri (32:32.372)
Mm-hmm.
Wilhelmina (32:37.486)
Teri (32:57.976)
Or they're taking hours to leave the bathroom because of contamination concerns. Right.
Vanessa (33:00.049)
The dysfunction, right? So even if they're not seeing what they're doing, they're like the outcome, right? The impact of the functioning is always where I'm saying, okay, you wouldn't be functioning as well as you are if this is what was happening with you. You wouldn't be getting the grades you're getting, getting to school when you needed to, doing all things if this was truly happening at that level of severity.
Lauren (33:00.775)
Right the bathroom right you see the impact on the functioning right, right
Wilhelmina (33:00.898)
We're here. We're here.
Lauren (33:12.221)
Right. Yeah.
Yeah, yeah, yeah, you're absolutely right. What about you, Vanessa?
Vanessa (33:23.153)
So I thought I would talk about ADHD. So this is something that we hear a lot about. I think both for in the adult world and also for children. I have, this is probably like the number one referral question that I have in my practice, is this ADHD? A lot of times it is, right? A lot of times parents come in and this absolutely is, but there are plenty of times where it's something else.
Wilhelmina (33:26.432)
Hmm.
Lauren (33:26.726)
Ha ha.
Mm-hmm.
Lauren (33:45.459)
Yeah. Yep.
Vanessa (33:51.701)
Or sometimes I'll have teens, right, nothing at all. I'll have teens who come in because they've told their parents, I think I have this. And they've watched a TikTok video of somebody saying, well, if you have this, this, and that, then you have ADHD because I have ADHD. And perhaps that person truly does. But to capture what ADHD is in a TikTok clip is probably not how it actually.
Lauren (33:52.627)
or nothing at all.
Lauren (34:03.465)
Mm-hmm.
Wilhelmina (34:14.668)
Yeah.
Teri (34:16.937)
Mm-hmm.
Lauren (34:17.245)
Not ideal.
Vanessa (34:18.127)
It's not ideal. That's not how it probably plays out in their lifetime. And I think there's a lot of misinformation about ADHD. And so we are hearing of people saying for the first time they're being diagnosed in adulthood. And that can happen. But ADHD is something that has to have begun in childhood. So there has to be a history of this in your childhood for this to actually be ADHD. And so I think historically we haven't been as good.
at diagnosing ADHD unless it was so severe. So I'm sure all of us can think about, you know, in our childhood, the kid in the class who like was running around the room and could, you know, so those kids probably got a diagnosis. Right. You know, those kids probably did, but not all of them. And so certainly we know that there are adults who did not get diagnosed as children who are struggling. So that's one reason why we do see an adulthood. But if you've never experienced
Lauren (34:50.505)
Right?
Teri (34:50.954)
Yeah.
Lauren (34:58.473)
fall back in his chair, right? Yeah.
No.
Vanessa (35:13.883)
you know, the challenges that someone has, has, you know, that has truly has ADHD, it's probably something else that's going on in your life. We know as adults, things like anxiety, depression can all impact your attention. We all, what was that? Hormones. Thank you Perry Moneypaws. Right. Right. Yes.
Lauren (35:22.431)
Bye.
Teri (35:28.532)
Hormones. Hormones.
Lauren (35:32.157)
Yeah, mental overload, right?
Wilhelmina (35:32.546)
Mm-hmm, mm-hmm, mm-hmm. Yeah, I was gonna say stage of life, stage of life. Mm-hmm, mm-hmm. Me too. Mm-hmm. Yes.
Teri (35:34.666)
Mm-hmm.
Lauren (35:37.289)
Just stage of life. Yes, I get a lot of moms, new moms that yes, yes. Yes. Yeah.
Teri (35:37.854)
gas.
Teri (35:42.345)
Yes.
Vanessa (35:42.555)
Yes, lack of sleep will make you forgetful, inattentive, disorganized. So there's all these life things that can happen in your life, right? They can certainly impact your attention. Another big part of ADHD is something we call executive functioning. And they often go hand in hand. Not 100%, but it's very high. And the way I like to think of executive functioning is it's your doing skills. It's your problem solving.
Lauren (35:51.356)
Yeah.
Vanessa (36:08.537)
It's your planning, it's your organization, it's starting a task, it's finishing a task, it's figuring out while you're doing a task, is my doing this the right way? Does it seem like it's turning, know, is the outcome gonna be good? If not, I'm gonna shift gears here. That's really your executive functioning skills. And as adults, that's actually what becomes more of the prominent issues in adulthood versus hyperactivity impulsivity or the attention piece that we see a lot in kids. Not that it can't be, but that seems to be the area where we see the most dysfunction in adults who truly have ADHD.
And then as far as the younger kind of kids and teens, particularly teens who come in, they'll come in, they'll tell their parents, think you have ADHD. And my rule is in my practice, I only go up to probably like early 20, so 22, 23. I have to have a parent involved in the evaluation process so that I can get really good history. I don't know what the adult providers are doing to get that history, but in my practice, when I have college students in there,
Teri (36:54.602)
100%.
Lauren (36:55.091)
same.
Vanessa (37:05.541)
I tell them I need a parent to be involved so that I can get some history because it is very challenging for individuals to really look back and be able to say, was this something that was difficult for me? So I really like that good history because as I mentioned earlier, ADHD is something that starts off in childhood. And so we need to have that good history saying, yes, that this is what happens.
And again, I think, you I talked about in adults where it could be anxiety, it could be depression, there's all these other things that can really impact your ability to stay focused, stay on task. The same thing, you know, is it's same for teens, right? Teens can experience anxiety. We know that teens are experiencing high rates of anxiety currently, thank you social media, and depression. And there are tons and tons of research and data that shows that...
Teri (37:45.416)
Mm-hmm.
Vanessa (37:53.495)
know, anxiety, depression can impact your attention, your processing speed, all of these things that are very common in ADHD. And so, you know, it's really important to be able to discern, you know, when did these symptoms start? You know, what did they look like and how have they kind of manifested across time to really be able to say, is this truly ADHD? I do think that there are a lot of adults who didn't get diagnosed early on, because, you know, like I mentioned, I don't think we were good at this.
Lauren (37:56.798)
absolutely.
Vanessa (38:19.229)
But I think it's really important to be able to rule out other things because you don't want to say this is ADHD when it's truly anxiety because they're not actually treating the root cause of the problem, right? And so if it's anxiety, you want to treat the anxiety, right? There is a high rate of comorbidity, which makes things more complicated. So we know that individuals with ADHD generally also have something else going on. And this includes even kids. So there's a...
Wilhelmina (38:30.67)
Thanks
Lauren (38:31.219)
Right.
Teri (38:37.45)
Mm-hmm.
Teri (38:45.844)
Mm-hmm.
Vanessa (38:45.947)
very high rate of ADHD. Whenever I'm diagnosing kids and I tell the parent like, okay, your child has ADHD and ODD and anxiety and something else. And I can see that this look of horror on their face. And I'm like, no, no, don't worry. This is more common than you think. It's very common. And the same in adulthood. So adults with ADHD also have high rates of comorbidity with all of the same things that I just mentioned. So it's not uncommon that there's more than one thing going on.
Teri (38:53.544)
Thank you.
Wilhelmina (38:59.246)
you
Lauren (39:00.895)
This is very common.
Vanessa (39:14.929)
which again sort of muddies the water and which again, that's why it's really important for us to get a good history and be able to really say like, when did these things start to happen and how are they manifesting? And that really helps us discern, you know, when this is truly ADHD versus something else or when they're both co-occurring. And the goal really then is to treat them both, right? You can't just treat one thing and not the other because you're still gonna continue to have some challenges if you can't treat both of them. The other interesting part about ADHD that I think people don't realize,
First of all, a lot of people will come in and say, have ADD, I don't have ADHD. So, ADD is an outdated term. It's changed. It's all ADHD, which stands for Attention Deficit Hyperactivity Disorder. And I know you're going to say, well, my kid is not hyperactive or I'm not hyperactive, how could I have ADHD? Well, that's because there's three different types of ADHD. There is the primarily inattentive presentation.
Teri (39:44.872)
Mm hmm. Yeah.
Wilhelmina (39:45.55)
Yep.
Lauren (39:45.575)
Yes, drives me crazy. Yes.
Teri (39:47.882)
Correct the terminology. Yeah. Yeah.
Lauren (39:59.999)
I
Vanessa (40:09.243)
So that is someone who meets the diagnostic criteria for the inattentive. So there's two sets of criteria. There's the inattentive criteria, there's a hyperactive impulsive criteria, and there's so many different symptoms that you have to meet for each one of these to be able to have one set or the other. So some people will meet criteria just for the inattentive type, so they have ADHD inattentive presentation. Those are gonna be my daydreamer, takes five hours to get dressed in the morning, to climb in their car seat.
I think I might have someone like that in my house. Yes. So that's the kid in the baseball field who's picking flowers and just kind of staring up. That's our inattentive kid. Then you have some kids who are primarily hyperactive impulsive. So maybe they don't have as much difficulty focusing, but they are just so full of energy, can't sit still, can't wait, they're turn of line. Right.
Teri (40:40.045)
you
Wilhelmina (40:40.054)
I was like, I think Griffin has ADHD. someone?
Teri (41:00.244)
Right, falling out of their chairs.
Lauren (41:03.518)
Right.
Vanessa (41:04.137)
shouting out answers, right? Interrupting you when they're talking, like that's the hyperactive impulsive. And then other folks, which I would say is probably the more common type, if we say for looking at both males and females, it's going to be the combined presentation, meaning they have both sets of symptoms. And so they struggle with both sustaining their attention, focusing, but then also the hyperactive impulsivity as well. So there's different types of ADHD. And so
Teri (41:05.236)
and
Lauren (41:07.881)
Mm-hmm.
Teri (41:08.074)
Mm-hmm.
Vanessa (41:28.591)
I always tell parents, I could fill a room with 100 kids with ADHD and they can all look totally different because they may have different types of ADHD and they may have different comorbidities. And so it's gonna look very different. And so that's also important for us to help to discern like, so if you truly do have ADHD, what type of ADHD? Because again, that's gonna drive the intervention, right? The treatment, the things that we recommend for that are gonna be different for somebody who is just inattentive versus someone who's just hyper, versus someone who has both symptoms.
Teri (41:32.831)
Yes.
Wilhelmina (41:32.888)
Mm-hmm.
Lauren (41:37.812)
Right.
Teri (41:39.082)
Yeah.
Wilhelmina (41:57.07)
So what would be an example of an adolescent or young adult who the executive dysfunctions you had mentioned? Because I feel like you see on Instagram all of these videos of this is what it's like to have ADHD. And it's people going through the house doing tasks, things like that. To be fair, I'm like, that's me. I have that. And so I want.
Teri (42:13.418)
Hmm
Vanessa (42:21.446)
Hahaha!
Lauren (42:21.759)
you
Wilhelmina (42:25.74)
What's an example of like, this is what executive dysfunction looks like out in the wild. Like this is actually what it looks like, not the TikTok version of it. Yeah, Terry.
Teri (42:34.024)
I have some. Showing up for work when it's not your day to work. I hear that a lot from young adults. They're like, I thought I had to work Tuesday. And I showed up and my boss was like, here's the schedule. You didn't check it. Not only did they not think to check the schedule on their phone, they just said, I thought I had to work Tuesday. So I got in the car and I drove here and I came. Even though there were some checks and balances and resources.
Lauren (42:42.11)
Yeah.
Teri (43:01.674)
calendars posted schedules for their part-time job that they could have checked. That one I've heard a few times. I also think when it comes to turning in work, work gets done does not get turned in. So you hear that a lot. Yes.
Wilhelmina (43:07.566)
interesting.
Vanessa (43:13.981)
Yeah.
Lauren (43:14.527)
Yeah.
Wilhelmina (43:17.678)
yeah.
Lauren (43:17.713)
Right?
Vanessa (43:17.809)
or keeping just track of keeping track of all the things that you need to do. So like, you know, a lot of people can just be like, I know what I need to do, right? Like, it's like, okay, I this like running kind of list in my head, but people with ADHD truly need to like write it down or, you know, like write it or keep it track of it, like actual in written form to be able to really say like, okay, this is what I need to do. And I need to, I've done it. Now I scratch it off, right? It's hard to keep that mental kind of list going. And really, but I was like,
Teri (43:22.088)
Yeah.
Lauren (43:24.125)
Or materials. Yeah.
Lauren (43:35.231)
Mm-hmm.
Lauren (43:45.012)
Yeah.
Teri (43:45.258)
or they'll write a list but never look at it. So I hear that a lot. Well, they'll say, I wrote it down. And they'll say, I have no idea where it is. They go, I wrote it down and I haven't seen it since. know, it's, yeah, it's gone.
Wilhelmina (43:47.778)
Yeah. So many lists.
Vanessa (43:47.921)
That too.
Lauren (43:52.319)
Right. Right.
Vanessa (43:56.569)
losing the list.
Wilhelmina (43:57.516)
because their desk is a chaotic, crazy mess.
Lauren (43:57.649)
I was going to say, or losing items in general that are important to them. So I hear a lot of losing of phones, losing of AirPods, like things like that, that keys, right? That they really struggle to keep track of items, even though those items are incredibly important to them, they really struggle to keep track of those things.
Vanessa (44:01.099)
Hahaha.
Teri (44:05.096)
Yeah. Losing phones, keys. Yeah.
Vanessa (44:09.339)
Misplacing things, yeah.
Teri (44:18.014)
With adults, hear a lot of forgetting to pay bills, things that are important, right? They'll forget to pay rent. Yes, yes, right.
Lauren (44:21.661)
Yeah, it'll sit there and they know they have to do it and they still don't follow through on it. So it's an awareness that they're having difficulty with functioning. that's one thing I was going say to Vanessa is you had mentioned before about the different kind of diagnostic criteria. And to some degree, we can see all of those things in ourselves, our kids, people we know, but it's if it impacts functioning.
Wilhelmina (44:22.422)
Yes.
Wilhelmina (44:27.82)
Yes.
Wilhelmina (44:34.092)
And it's a really, yeah.
Vanessa (44:46.438)
yeah.
Functioning, yes, yeah, yeah, yeah.
Teri (44:49.108)
Yes, yes.
Wilhelmina (44:49.57)
Yes.
Lauren (44:50.141)
Right? Because we can all kind of say that a little bit, but it's, that's, think the, the danger of these social media videos is they will say it so kind of, flippantly. Right. And it's like, okay, but we're all that way to some degree. And, and we have to be really careful about, does this impact my functioning? No. Right.
Wilhelmina (44:55.426)
Yes.
Wilhelmina (44:59.938)
Broad strokes, yeah.
Vanessa (45:01.425)
Yeah, right.
Vanessa (45:09.127)
Right. That's that.
Teri (45:09.17)
It's the kids who can't make it through freshman year of college, right? We do lots of those evaluations all the time. Every Thanksgiving break and spring, we're getting evaluations for those of us who do testing because they maxed their skills. They went away to college and exactly, exactly.
Lauren (45:13.779)
Right. Yes.
Vanessa (45:25.341)
or they don't have the parent support there anymore. Because the parents will say, I was there like, I was their frontal lobe. Yes, like I was doing all of this for them. Now they're on their own and they're really having a hard time keeping up with the test. And that's why I like to include the parent, right? Because they can sit there and say, I probably did too much for them. I was doing a lot for them, right? And so you can see them start to fall apart when they don't have that.
Lauren (45:26.495)
I was going to say there was a high level of scaffolding.
Wilhelmina (45:26.796)
Yes, I was gonna say parents.
Lauren (45:35.295)
Yep, that scaffolding is gone. I have to. Yep. Yep.
Teri (45:37.992)
Right. Right.
Lauren (45:49.299)
Yeah, that's incredibly helpful. Right. Yes, I think we'd say that for everything. Yes. Yes. Yes. Do less. Yes. Yeah.
Wilhelmina (45:49.944)
public service announcement for parents, do less for your adolescent child. Do less everything.
Teri (45:57.566)
Yeah. Do less, do less for your kids in general. Do less. Okay.
Vanessa (45:57.723)
Yeah. Everything. Yeah. Yeah. But that function part, think, Lauren, is a really good point. And that's something I say a lot, to clients who come in. like, there's probably a lot of people walking around with a meat criteria for ADHD, and they're not getting diagnosed or coming in for an evaluation because they figured out how to function. They figured out what works for them and what doesn't. So it's really about how does this affect you? Because there's also, in addition to which type of ADHD you have, there's actually different
Wilhelmina (46:03.128)
Yes. Yes.
Wilhelmina (46:16.75)
Mm-hmm.
Lauren (46:16.883)
Yeah. Yep. Yep.
Vanessa (46:27.229)
It's a spectrum. So it can be mild, could be moderate, severe. And that can also determine how much this is impacting your function, whether or not you decide to treat it with medication. That's a big one. Not everybody who is diagnosed with ADHD takes medication and needs it, right? So some people are able to, again, figure out how things work for them without medication. But we also know medication can be extremely life-changing. I cannot tell you how many times a parent has come back for a reevaluate of the child and they're like, it is...
Lauren (46:28.596)
Yeah.
Wilhelmina (46:38.638)
Thank you.
Lauren (46:38.707)
Yeah.
Vanessa (46:56.559)
It has saved our lives. Like, I can't even tell you how impactful this has been.
Teri (46:57.182)
Well, yeah.
Lauren (46:57.843)
Yeah.
Teri (47:01.81)
And something to clarify is that medication, medication, both stimulant and non-stimulant will help anybody with or without ADHD. So it's highly effective, which is why it's the most commonly abused prescription medication, because it helps everybody focus. There used to be a myth when we were younger that that would help differentiate the diagnosis. If you don't have ADHD and you take it, it won't help you. But truly it helps, it would help anybody a non-
Lauren (47:09.523)
Yes.
Vanessa (47:10.139)
Right, right, it's highly effective.
Lauren (47:15.763)
Yeah.
Lauren (47:24.189)
Yeah, right. It won't work, right.
Wilhelmina (47:24.28)
Yes.
Vanessa (47:25.287)
Right. Right.
Lauren (47:29.823)
right. Yeah. Yep.
Teri (47:30.664)
ADHD brain or non ADHD brain medication is going to help you because it's a stimulant.
Vanessa (47:35.271)
And I think another thing to highlight too is the misinformation about substance abuse and people who take ADHD are going to become drug users. I cannot tell you how many times I've had people say, well, that leads you to using drugs. And I say quite the opposite, actually. If you look at the research, untreated ADHD leads to higher rates of dropping out of school, unemployment, and self-medication. And that really goes true for any mental health issue that is not addressed.
Lauren (47:35.337)
Right.
Lauren (47:49.085)
No, it's a preventative. Mm-hmm. Yeah.
Wilhelmina (47:49.762)
No. Yes.
Teri (47:52.201)
Right.
Teri (47:56.383)
Yes.
Lauren (47:57.765)
a self-medicate. Yeah.
Wilhelmina (47:57.934)
Mm-hmm.
Lauren (48:03.005)
Yeah. Yeah. Yep.
Teri (48:03.41)
I just told a set of parents that this morning when they asked. I said, actually, if your child requires medication, especially due to impulsivity, especially, who do you think is going to dabble in hardcore drugs when they're a teenager? Kids with impulsive tendencies. Yes. Alcoholism, yeah.
Vanessa (48:05.181)
Hi. Yes.
Lauren (48:09.577)
like decreases. Yes.
Vanessa (48:11.141)
Yes.
Lauren (48:15.773)
Right, right, right. Yeah. Yep. Yep. Yep. Yep. Yep. Terry, we could probably do a whole episode on ADHD, but I know that there was another topic that we wanted to make sure we covered it with regard to social media and misdiagnoses or mischaracterizations. What do you got?
Wilhelmina (48:16.504)
Yeah. Yep. Yep.
Vanessa (48:17.785)
Exactly. Even adults, that's one of the things that we still see in adults. Impulsivity, substance abuse. So actually you need to treat your child's ADHD.
Teri (48:24.554)
Yeah. All right. Yeah.
Vanessa (48:32.253)
You
Teri (48:32.862)
Yes.
Teri (48:40.616)
And I'm going to keep mine brief because I feel like mine is the least prevalent, but it's what I'm hearing and seeing a lot at my practice. yes. So, but in the general population and some people might not even be familiar with this term. So it is dissociative identity disorder or DID, which was formerly known in our old manuals as multiple personality disorder. I up until maybe two or three years ago, and some of you might agree,
Lauren (48:47.966)
I would agree.
Wilhelmina (49:03.872)
huh.
Teri (49:10.224)
never ever in my whole career or in my training had someone present with a referral question of, I have dissociative identity disorder? In fact, because it is so rare. And there was a lot of debate, the task force for the DSM-5, which is our current diagnostic manual, the task force, which is basically a group of clinical psychologists who delve deep into the current research, the longitudinal studies, they did debate removing it from this edition.
Lauren (49:12.439)
my gosh.
Vanessa (49:20.251)
because it is so rare.
Lauren (49:23.487)
So rare.
Teri (49:39.722)
I hypothesize it will not exist in future editions of the DSM or it will be rebranded. What people are reporting, what I'm hearing from a lot of the evaluations I do with teenagers and young adults, they will say things like, I think I have DID, it's a very hot TikTok diagnosis. I'd like to be, they have asked their parents, I would like to be tested for DID. And what they're really talking about in the phrases, the two phrases they come to my office most often are depersonalization and derealization.
Lauren (49:56.318)
Yes.
Lauren (50:07.055)
Yep. Yep.
Wilhelmina (50:07.362)
Mm-hmm. Mm-hmm.
Teri (50:09.412)
And for those who aren't aware, depersonalization is defined as a persistent feeling of observing oneself from outside one's body or having a sense that one's surroundings aren't real. So what I often talk about with teens and young adults is those feelings are likely legitimate and real. You are having those experiences. However, the odds that this is related to a dissociative identity disorder are very low.
Wilhelmina (50:29.398)
Mm-hmm. Mm-hmm.
Lauren (50:29.641)
Yep. Yep.
Teri (50:37.606)
it is much more likely you are experiencing depression, anxiety, hopefully sometimes not, but maybe some prodromal psychosis if somebody has some pretty severe depression or there's a possible psychotic disorder, especially if there's some genetic or family history, trauma, speaking of trauma, that can definitely be a trauma response is depersonalization, substances, drug, drug, drug.
Vanessa (50:41.607)
Mm-hmm.
Wilhelmina (50:41.88)
Mm-hmm. Mm-hmm.
Lauren (50:42.63)
anxiety.
Wilhelmina (50:48.398)
Mm-hmm.
Lauren (50:48.745)
Right.
Vanessa (50:55.471)
Mm-hmm. Yep.
Wilhelmina (50:57.314)
Mm-hmm.
Lauren (50:57.353)
Right.
Wilhelmina (51:01.346)
Drug use, drugs.
Lauren (51:02.803)
I was gonna say.
Teri (51:05.168)
Some of many of the same individuals who tell me they're experiencing depersonalization are popping edibles on a daily basis. Yes.
Wilhelmina (51:08.322)
Mm-hmm.
Wilhelmina (51:12.482)
Yes, I smoke pot or eat an edible every single day. And then I feel very out of it. I'm like, yes, you do.
Vanessa (51:12.758)
Teri (51:17.416)
Yes. Yes. Yes. Because you are high. You are actually high. You don't have more. Welcome. So there's you, not high. There's you high. Those are two different personalities. That's just you being high.
Vanessa (51:18.565)
Because you are high.
Lauren (51:21.641)
Shocking.
Wilhelmina (51:28.91)
You're just fine!
Lauren (51:31.037)
Right.
Wilhelmina (51:34.85)
What's that song? And then I got high like, you're just high.
Teri (51:36.734)
Yes. Yes. You're just high. So I want, so part of the reason I think it's important to mention this is that if anybody has a teen or young adult in their orbit who is very attached to tick tock diagnoses, depersonalization, derealization, DID is even a term that you might hear them toss out. And I think it's important that there's some clarity around that.
Lauren (51:37.709)
my god.
Lauren (51:43.131)
my gosh.
Lauren (51:50.025)
Yeah.
Teri (52:02.974)
that while yes, they might be experiencing what they are interpreting as depersonalization, it is highly unlikely to be DID. It is much more likely to be trauma, substance-related depression, anxiety, prodromal psychosis, all of the above, maybe one of the above or two of the above. But that is where terminology is important. Clarification is really important. And also helping people understand that what they think they are experiencing
Lauren (52:03.263)
Yeah.
Lauren (52:19.07)
Yeah.
Wilhelmina (52:23.48)
Yes.
Teri (52:32.212)
can be real, but let's dig a little bit deeper. Let's work with a trained clinician who has, yes, what is the true cause of this? What is the etiology of this? What is driving this? Because the other piece that I think is important to mention is that teenagers and young adults and even older adults are always looking for identity formation. And part of the reason this or any disorder actually, any label we've talked about, even ones we haven't mentioned today,
Vanessa (52:35.217)
Right. Like what's the true ideology of this? Like why, yes.
Lauren (52:39.293)
Yep, right, right, right.
Wilhelmina (52:52.013)
Yeah.
Lauren (52:52.351)
Yes.
Teri (52:59.038)
The reason it feels so important is that it is a developmental task of adolescents to work on identity formation. And this is their job. They're supposed to be figuring out what they like, what they don't like, what their values are, if their behaviors are in accordance with their values, who they're hanging out with, who they want to date, what they want to be when they grow up. And yes, that's right. That's so normal. And historically, pre-social media, pre-TikTok,
Wilhelmina (53:04.747)
Mm-hmm.
Lauren (53:05.097)
Yep. Yep, this is their job. Yeah. Yep.
Vanessa (53:08.285)
Mm-hmm.
Wilhelmina (53:08.396)
Yes. Yep.
Wilhelmina (53:19.358)
Yeah, trying on different personalities, different things. That's normal. It's all normal.
Teri (53:28.734)
That was done through activities and friends. That was done through joining theater, playing sports, being in the band, dating whoever, hanging out with this group. right. I switched friend groups. I'm not in that friend group anymore. I'm in this friend group now, or I'm part of all the friend groups. What has been happening is teenagers are often using their phone to try out new identities because they're not engaging in real life experiences. And so when you are trying on or trying to identity seek,
Lauren (53:31.529)
Yes!
Wilhelmina (53:37.954)
Going to concerts, yeah.
Wilhelmina (53:50.008)
Mm-hmm.
Lauren (53:50.079)
Yep. Yep. Yep.
Vanessa (53:54.205)
Thank
Teri (53:58.696)
via social media, TikTok, Instagram, et cetera, this is some of what's out there, things like DID, and they're trying to figure out who they are.
Wilhelmina (54:04.312)
Yeah. Yeah.
Lauren (54:05.759)
Terry, you had mentioned a few episodes back when we did discuss the social media impact that phones, social media are experienced blockers. And this is exactly what it's blocking is that identity formation. That it was like such a perfect way of describing what is exactly happening. It's blocking their identity formation. You cannot form an identity by watching somebody on TikTok. You cannot. But that's what's happening.
Vanessa (54:05.809)
Mm-hmm.
Teri (54:16.98)
Yes.
Wilhelmina (54:17.26)
Mm-hmm. Mm-hmm.
Wilhelmina (54:30.08)
No, no.
Lauren (54:33.405)
which is what we end up then seeing, why we end up seeing these incredibly rare diagnostic profiles being questioned in our practices. Do I have DID?
Teri (54:43.934)
And the other thing I would mention.
Wilhelmina (54:44.034)
You cannot figure out who you are in front of a screen. You have to be out in the world, interacting with the world, with your environment, with people. You will never figure out who you are based on a screen, based on staring in front of a
Teri (54:47.786)
can't.
Vanessa (54:55.741)
Right, right, right. Because you have to learn from your successes and your failures, right? Like you're gonna do things great and that's gonna help you discern who you are and you're gonna suck at things. And that's also part of becoming who you are. And you can't do that in the safety of your bedroom. Like you can't.
Lauren (55:12.521)
Terry, what were you going to say?
Teri (55:12.714)
The other thing I was going to say, just thinking about all of this in total is something called the Barnum effect. If you might remember this from any social psychology classes, which the best example I can think of is you read a horoscope and you find yourself in that description. It's called the Barnum effect. that's me. that's me. And then the next week, that's me again. They just know me so well. And the Barnum effect has been well studied.
Lauren (55:19.527)
Yes. Yeah. Yeah. I love that.
Wilhelmina (55:20.398)
Yes.
Vanessa (55:21.797)
Hmm.
Lauren (55:27.103)
Yep. Yes. This is me. Yeah.
Vanessa (55:29.735)
Yeah, that's me.
Wilhelmina (55:29.741)
Yes.
Lauren (55:35.785)
Yeah. All right.
Wilhelmina (55:36.493)
Ha!
Teri (55:40.774)
there's some good substantial data to support it that if we read a description of something, a personality type, a horoscope, a diagnosis, we are pretty skilled at finding ourself in that description. So always keep in mind, yes, exactly. So I think keeping in mind when you see anything, whether it's related to yourself personally or your kids or family members or friends, know that the Barnum effect is probably at play somewhat.
Lauren (55:48.127)
Right.
Wilhelmina (55:52.302)
Mm-hmm.
Lauren (55:52.863)
Yeah, the fortune cookie, you know.
Wilhelmina (55:56.714)
yeah.
Lauren (56:07.737)
Absolutely.
Wilhelmina (56:08.258)
That's a good point.
Vanessa (56:08.689)
Yeah. Well, we could probably talk more about this. And maybe we will on another podcast talk about more of these different mental health diagnoses that we're hearing about, more about the impact of social media on that. But thank you. Well, actually, before I say thank you to everyone, any other thoughts on our topic today? That was a good chat.
Teri (56:26.878)
No.
Wilhelmina (56:27.618)
But definitely send us an email or if there's a topic that you're like, I want to know more about this, or if you have a question about it. Because we absolutely have enough to do a part two for this.
Vanessa (56:35.517)
Yeah, absolutely.
Lauren (56:35.817)
Yeah.
Lauren (56:39.828)
Yeah. And three and four.
Vanessa (56:40.701)
Yeah, so if there's anything you've, anyone listening, if there's something that you've heard about that you wanna know more about, or whether it be from your social group circle or your kids or anything like that, you can send us an email. You can also message us on Instagram as well. We're there too. Well, thank you for joining us today on our discussion about social media and mental health diagnoses. We hope that you welcome, sorry, we hope that you join us next time on The Shrinked Down.
Wilhelmina (56:53.122)
Mm-hmm.
Lauren (56:53.331)
Yeah.